Accuracy of perfusion MRI with high spatial but low temporal resolution to assess invasive breast cancer response to neoadjuvant chemotherapy: a retrospective study.

Cédric De Bazelaire 1, 2, * Raphael Calmon 1, 2 Isabelle Thomassin 3, 4 Clément Brunon 3, 5 Anne-Sophie Hamy 6 Laure Fournier 3, 5 Daniel Balvay 3, 5 Marc Espié 6 Nathalie Siauve 3, 5 Olivier Clément 3, 5 Eric De Kerviler 1, 2 Charles-André Cuénod 3, 5
* Auteur correspondant
1 Gvh et Gvl : Physiopathologie Chez l'Homme et Chez l'Animal, Incidence et Role Therapeutique
2 Service de radiologie [Saint-Louis]
3 PARCC - U970 - Paris-Centre de Recherche Cardiovasculaire
4 Service de radiologie
5 Service de radiologie cardio-vasculaire [CHU HEGP]
6 Centre des maladies du sein
Abstract : UNLABELLED: ABSTRACT: BACKGROUND: To illustrate that Breast-MRI performed in high spatial resolution and low temporal resolution (1 minute) allows the measurement of kinetic parameters that can assess the final pathologic response to neoadjuvant chemotherapy in breast cancer. METHODS: Breast-MRI was performed in 24 women before and after treatment. Eight series of 1.11 minute-duration were acquired with a sub-millimeter spatial resolution. Transfer constant (Ktrans) and leakage space (Ve) were calculated using measured and theoretical Arterial Input Function (AIF). Changes in kinetic parameters after treatment obtained with both AIFs were compared with final pathologic response graded in non-responder (< 50% therapeutic effect), partial-responder (> 50% therapeutic effect) and complete responder. Accuracies to identify non-responders were compared with receiver operating characteristic curves. RESULTS: With measured-AIF, changes in kinetic parameters measured after treatment were in agreement with the final pathological response. Changes in Ve and Ktrans were significantly different between non-(N = 11), partial-(N = 7), and complete (N = 6) responders, (P = 0.0092 and P = 0.0398 respectively). A decrease in Ve of more than -72% and more than -84% for Ktrans resulted in 73% sensitivity for identifying non-responders (specificity 92% and 77% respectively). A decrease in Ve of more than -87% helped to identify complete responders (Sensitivity 89%, Specificity 83%). With theoretical-AIF, changes in kinetic parameters had lower accuracy. CONCLUSION: There is a good agreement between pathological findings and changes in kinetic parameters obtained with breast-MRI in high spatial and low temporal resolution when measured-AIF is used. Further studies are necessary to confirm whether MRI contrast kinetic parameters can be used earlier as a response predictor to neoadjuvant chemotherapy.
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BMC Cancer, BioMed Central, 2011, 11 (1), pp.361. 〈10.1186/1471-2407-11-361〉
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Cédric De Bazelaire, Raphael Calmon, Isabelle Thomassin, Clément Brunon, Anne-Sophie Hamy, et al.. Accuracy of perfusion MRI with high spatial but low temporal resolution to assess invasive breast cancer response to neoadjuvant chemotherapy: a retrospective study.. BMC Cancer, BioMed Central, 2011, 11 (1), pp.361. 〈10.1186/1471-2407-11-361〉. 〈inserm-00623267〉

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